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Theory and Practice of Counseling - PSY632

LESSON 24

CLASSICAL PSYCHOANALYTIC APPROACH

It has been mentioned before that a case approach will be employed to understand various concepts of

different theoretical approaches to counseling. In the following, case history of a female client is presented

in order to use it as a reference for explaining main concepts of some theoretical approaches

Case History: Raheela

The client is a 43-yearold female. She is the eldest of 5 children and was raised in a large urban city. She is a

college graduate, has taught Math and Science in a high school for the past 4 years, and tends to pour all of

her energy in her students, which often causes a strained relationship with her own children. She is divorced

from her husband of 5 years; the divorce was very much opposed by her parents and family.

She has complaints of insomnia, not eating properly, frequent unexplained crying spells, depression, and

lack of concentration. She has sought help from some Maulvi sahib, co-workers and her mother.

Other important information includes the fact that she took care of her brothers and sisters growing up

because of her parent's busy schedules. She also describes a dream that she has had on several occasions:

"I am always running and there are shadowy figures behind me. I am in a large warehouse.

There are boxes marked with arrows reading "Exit". The arrows are all going in different

directions, therefore I never find my way out and the figures keep getting closer. I wake up

in a cold sweat, breathing rapidly, heart pounding, and a scream stuck in my throat".

Psychic Determination

· Mental activity is not meaningless or accidental. Nothing in the mind happens by chance.

· Mental phenomena have a causal connection to the psychic events that precede them. Hence there is a

continuity between childhood experiences and adult problems and therefore an understanding of

childhood experiences provide a clue to later problems.

· Raheela's case: Psychological causes outside of client's conscious awareness caused problems in adult

life.

Anxiety

· What Is It? a painful affective experience; Something that motivates us into action...

· Three Types

o Reality

Fear of danger from outside world.

o Neurotic

Fear that instincts will get out of hand causing punishment.

o Moral

Fear of one's own conscience.

Ego Defenses: Types

Ego defenses protect a person from being over whelmed by anxiety through adaptation to situation or

through distortion or denial of events. They are normal and operate on unconscious level. Anna Freud

(1936) and other ego psychologists formulated strong ideas about defense mechanisms by elaborating on

Freud's original ideas. Among the main defense mechanism are the following:

· Repression can be described as the banishment from consciousness of highly threatening sexual or

aggressive material. Repression is the most basic defense mechanism, the one on which others are built. The

ego must use energy to keep excluded areas from consciousness, but some times the repressed thoughts slip

out in dreams or verbal expressions. Sets up within the mind a long-lasting opposition between the ego and

the id. Repression is considered the cornerstone or foundation-stone of psychoanalysis.

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Theory and Practice of Counseling - PSY632

· Reaction formation is said to occur when an unconscious impulse is consciously expressed by its

behavioral opposite. For example, a host at a party may shower a disliked guest with attention. A Reaction

Formation is often detected because of the intensity with which the opposite emotion is expressed.

· Projection is revealed when one's unconscious feelings are attributed not to oneself but to another. For

example, a woman may say that her is boss is angry at her instead of saying that she is angry at her boss.

Prejudice defines a culturally defined projection, where the unwanted traits in one's own group are

projected to a usually subordinate group.

· Regression is return to an earlier mode or object of gratification. It can also be used defensively in the

face of trauma. Person moves backward in time to a stage that was less anxiety-provoking and that had

fewer responsibilities.

· Displacement channels energy away from one of them to alternative-that is, to a safe target. For

instance, a person who has had a hard day at the office may come home and yell at the child.

· Sublimation refers to channeling the drive into constructive activities. A positive form of displacement

is known as sublimation, in which a drive that can not be expressed directly is channeled into constructive

activities. For example, those who are unable to express themselves sexually may take care of children.

Freud thought sublimation was a major means of building civilization. It can be view as a normal function

of the ego, working to satisfy the demands of the id and the environment as fully and efficiently as possible

(e.g., playing football).

· Intellectualization is the ignoring the emotional aspects of a painful experience by focusing on

abstract thoughts, words or ideas, in other words trying to justify some irrational act by intellectualizing.

Denial: Protecting oneself from an unpleasant reality by refusing to perceive it.

Undoing involves taking back, as a result of anxiety produced by the original acts/ statements Activity.

Role of the Counselor

· Professional who practiced classical psychoanalysis play the role of experts. They encourage their

clients to talk about whatever comes to their mind, especially childhood experiences.

· To create an atmosphere in which the client feels free to express difficult thought. Psychoanalysts,

after face to face session.

· The analyst's role is to let clients gain insight by relieving and working through the unresolved past

experiences that come into focus during sessions.

· The development of transference is encouraged to help clients deal realistically with counselor to

interpret for the client.

· Overall, the counselor employs both active and passive techniques.

· Psychological assessment instrument, especially projective tests such as Rorschach inkblots, a sum

times employed.

Goals

· In most cases a primary goal is to help the client become more aware of the unconscious aspects of

his or her personality. Psychoanalysis strives to help clients gain insight into them.

· A second major goal, often tied to the first, is to help a client work through developmental stage

not previously resolved.

· A final goal is helping clients cope with the demands of the society in which they live. Unhappy

people, according to this theory are not in tune with themselves or society. The focus is on

strengthening the ego so that perceptions and plans become more realistic.

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Theory and Practice of Counseling - PSY632

Techniques: From Theory to Practice

Freudian techniques are most often applied within a specific setting, such as the office of a counselor or the

interview room of a hospital. Although each technique is examined separately here, in practice they are

integrated.

· Free association: During free association, the client abandons the normal way of censoring thoughts

by consciously repressing them and instead says whatever comes to mind, even if the thoughts seem silly,

irrational, suggestive, or painful. "Know themselves" through working through buried feelings is the main

focus of free association. "Talking cure" became transformed into free association during Freud's work with

Elisabeth, a client of him. The psychoanalyst assumes that one association will lead to another. As the

process continues, one gets closer and closer to unconscious thoughts and urges.

· Analysis of Resistance: Sometimes clients initially make progress while undergoing psychoanalysis

may take many forms, such as missing appointments, being late for appointments, not paying fees,

persisting in transference, blocking thoughts during free association, or refusing to recall dreams or early

memories. When resistance occurs in any form, it is vital that the counselor deals with it immediately. It can

show in various behaviors of the client, like if client pauses, jokes, changes the subject or mind goes blank

or unable to remember. The blocks in the flow of free associations are resistances. It suggests anxiety and

repression relevant to some sensitive material.

· Analysis of transference: Transference is the client's response to a counselor as if the counselor were

some significant figure in the client's past, usually a parent figure. The analyst encourages this transference

and interprets the positive or negative feelings expressed. Suggest underlying wishes, feelings and conflicts -

aid to provide people with insight into what patient is avoiding.

· Analyst's interpretations: Interpretation should be considered part of the four techniques we have

already examined and complementary to them. When interpreting the counselor helps the client understand

the meaning of past and present personal events. Interpretation encompasses explanations and analysis of a

client's thoughts, feelings, and actions. Counselor must carefully time the use of interpretation.

Analysis of Dreams

· Dreams, according to Freud, are the royal road to the unconscious. These are thought to reveal the

nature of the unconscious because they are regarded as heavily laden with unconscious wishes.

· Dreams are seen as symbolic wish fulfillments that often provide, like free associations,

important clues to childhood wishes and feelings.

The manifest and latent content of the dreams: The latent content of a dream is its symbolic

meaning. In order to get at the latent content, the patient is often encouraged to free-associate to a

dream with the hope of gaining insight into its meaning.

The real meaning of a dream in the life of an individual may only become apparent from the

analysis of a whole series of dreams. Patients often distort the actual content of a dream as they

retell it during the analytic session.

Raheela's Case

o The warehouse would unconsciously represent a place that holds things (comfort as in

being held).

o A large warehouse gives the meaning of much open space, perhaps emptiness.

o She turned to various people for comfort but found no way out of the emptiness.

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